Gastrectomy

A gastrectomy is the surgical removal of all or part of the stomach. The stomach is a J-shaped organ in the upper abdomen. It is part of the digestive system, which processes nutrients ( vitamins, minerals, carbohydrates, fats, proteins, and water) in foods that are eaten and helps pass waste material out of the body.

Food moves from the throat to the stomach through a hollow, muscular tube called the esophagus. After leaving the stomach, partly-digested food passes into the small intestine and then into the large intestine.

Gastrectomy is performed for the following conditions:

• Stomach Cancer
• Bleeding Gastric Ulcers
• Perforation (Hole) in the Stomach Wall
• Benign Polyps

A partial gastrectomy is the removal of only part of the stomach. The remaining portion then continues with its digestive role. If the entire stomach is removed, the esophagus is connected directly to the small intestine, where digestion now begins.  Patients must make significant dietary changes when a gastrectomy is performed. 

For severe gastric ulcers involving the duodenum, the pylorus, the lower portion of the stomach, may be removed along with the all or part of the duodenum, the upper portion of the small intestine. 

A Billroth procedure is then preformed. Where a sufficient portion of duodenum remains, a Billroth I is performed where the remaining stomach is reattached to the duodenum before the bile duct and pancreas ducts. If the stomach cannot be reconnected to the duodenum, a Billroth II is performed, in which an opening hole is made in the next section of the small intestine, the jejunum, and the stomach attached at that opening.

The pylorus is used to grind food and slowly release it into the small intestine. Its removal causes food to move more rapidly through the small intestine, often leading to gastric dumping syndrome, a condition treatable via change in diet.